Warfarin may have more benefits for under 60s

The advantages of using warfarin over aspirin in heart failure patients appears to be age-related, with patients under 60 getting the most benefit, suggests a new study.

Younger patients account for the greater share of risk reduction for stroke, brain bleeds and death said Dr Shunichi Homma of the Columbia University Medical Centre in New York City, and his colleagues.

The younger patients also had the benefits without an increase in major bleeding, the researchers wrote in the study published online in Circulation: Heart Failure.

Patients older than 60 in this sub-analysis saw no difference between warfarin and aspirin in outcomes after a three year follow-up.

But when researchers looked at major bleeding, the use of warfarin in older patients was significantly associated with worse outcomes. Younger patients on warfarin saw a relative 32 per cent reduction in adverse events.

In May, the European Heart Failure Association issued new guidelines that stipulate heart failure patients without the irregular heart rhythm atrial fibrillation should not routinely receive anti-clotting drugs.

The study had several limitations, the authors said, including the use of variables that were not prespecified, no placebo group, and no clear mechanism for the results.